Clinical features and laboratory findings in mad honey intoxication: a retrospective study

Objective: Mad honey intoxication results from consuming honey which is produced from rhododendron flowers and containing Grayanotoxin (GTX). This intoxication is seen rarely, however it may lead some life-threatening signs. In this study, it was aimed to retrospectively discuss the effects of 38 mad honey intoxication cases on the organs in the light of demographic and biochemical blood gas parameters.
Material and Methods: We enrolled 38 patients diagnosed with “mad honey intoxication” retrospectively, who were admitted to our emergency department between January 2010 to December 2012.
Results: Of cases, 23 (60.5%) were male and 15 (39.5%) were female. Our cases were between the ages of 29 and 86 years. The mean age of cases was 55.42±12.63 years. The mean onset of symptoms after honey intake was determined to be 92.82±30.09 minutes. The mean heart rate when cases applied to hospital was found to be 49.74±11.41 beats/min. and the mean systolic and diastolic blood pressures were found to be 72.16±16.92 mmHg and 43.79±10.58 mmHg, respectively.
The mean amount of atropine treatment given to the patient was found to be 0.76±0.55 mg and the mean crystalloid fluid given was 1336.84±935.31 mL. Except the rhythm problems, gastrointestinal, respiratory and cardiovascular system findings were in normal range. There was no correlation found between the amount of honey consumed and the onset of symptoms in the cases.
Conclusion: Mad honey intoxication most often affects the cardiovascular system. Hypotension and bradycardia are the most common signs in these patients. Sufficient fluid hydration and 1-2 mg intravenous atropine are often adequate for the treatment.

Deli bal zehirlenmesinde klinik özellikler ve laboratuar bulgularý: Retrospektif bir çalýþma

Amaç: Deli bal zehirlenmesi; Rhododendron çiçeklerinden üretilen ve içinde Grayanotoxin (GTX) bulunan balýn tüketilmesi sonucunda oluþur. Oldukça nadir görülmesine ragmen hayatý tehdit eden bulgulara sebep olabilir. Bu çalýþmada hastanemize baþvuran 38 deli bal zehirlenmesi vakasýnýn demografik ve biyokimyasal kan gazý paremetreleri ýþýðýnda organlar üzerindeki etkilerinin retrospektif olarak literatür eþliðinde tartýþýlmasý amaçlanmýþtýr.
Gereç ve Yöntemler: Çalýþmaya 2010-2012 yýllarý arasýnda acil servise herhangi bir þikayetle baþvurmuþ ve ‘Deli Bal Zehirlenmesi’ tanýsý almýþ toplam 38 hastanýn retrospektif datalarý dahil edildi.
Bulgular: Olgularýn 23 (%60.5)’i erkek, 15 (%39.5)’i bayandý. Olgularýmýz 29 ile 86 yaþlarý arasýndaydý. Olgularýmýzýn yaþ ortalamalarý 55.42±12.63 yýl olarak belirlendi. Olgularýn bal alýmý sonrasý semptomlarýn baþlama süresi ortalama 92.82±30.09 dak olarak belirlendi. Olgularda hastaneye baþvurudaki kalp atým hýz ortalamasý 49.74±11.41 atým/dak, ortalama sistolik kan basýncý deðeri 72.16±16.92 mmHg ve ortalama diyastolik kan basýncý 43.79±10.58 mmHg olarak bulundu. Hastalarýn ortalama 0.76±0.55 mg atropin ve 1336.84±935.31 ml kristaloid sývý ile tedavi edildiði bulundu. Ritm problemleri dýþýnda gastrointestinal, solunum ve kardiyovasküler sistem bulgularý normal sýnýrlardaydý. Olgularýn bal tüketim miktarlarý ile, semptomlarýn baþlama süresi arasýnda bir korelasyon iliþkisi belirlenemedi.
Sonuç: Deli Bal Zehirlenmesi en sýk kardiyovasküler sistemi etkilemektedir. Bu hastalarda en sýk hipotansiyon ve bradikardiye rastlanmaktadýr. Tedavide sýklýkla yeterli sývý resüsitasyonu ve 1-2 mg Ýntravenöz Atropin tedavisi yeterli olmaktadýr.